Based on what you can see in these pics, what would you think would be best to correct my scarring? (Photos)

In keeping with the principle that the simplest solutions are often the best solutions, consider "Field Subcision" for improving the general acne-related facial atrophy that makes the face appear gaunt and the overlying scars more prominent. Once this is done, then individual subcisions may be performed for elevating and smoothing residual boxcar and rolling scars and TCA CROSS used for improving ice pick scars and dilated pores. All of the aforementioned technqiues have distinct advantages over the use of "bells and whistles," light and energy-based devices; they have several decades of a proven track record for efficacy and safety in all skin types, while the expensive machines cannot say the same. The hard science to support their use lags well behind the heavy marketing to promote them. Microneedling is fine, but not as a monotherapy for deep acne scars. It is much better as a final "polishing" step for helping to blend treated areas with the surrounding normal skin. Make sure to consult with an experienced, board certified cosmetic dermatologist and not just any venue hawking thiis or that supposedly "next big thing" that it has just purchased. Hope this helps. Best of luck.

Dear patient, Your olive skin tone makes treating you slightly more challenging. I think you are on the right track but need much more aggressive treatments. I believe that you have 2 options: very aggressive CO2 laser with fillers and subcision or several sessions of a device called Venus Viva with Subcision and fillers. 
Take your had and pull up your cheeks. Do the scars get better. If the answer is yes you would benefit from a procedure that can tighten the skin. Cystic acne causes degradation of the Collagen and Elastic fibers and the skin sags. Adding a tightening element to you regimen can significantly improve the scarring. I prep my patients for 1-2 weeks with Retin and Bleaching cream and perform aggressive Co2 laser (Mixto) and Subcision and Sculptra. The problem is that healing can take 7-10 days. The other option is a deice called Venus Viva. This device is a nano fractional Radiofrequency coupled with micro-needling. It penetrates deep into the kin and tightens in addition to improving acne scars. I usually combine this with Sculptra or Bellafill fillers and Subcision. Downtime is only 2-3 days but more than one session is needed. I hope this was helpful. Yours, r David R.

Hello, 
Thank you for your question. Unfortunately acne scars are one of the most difficult things to treat. More often than not, they will Not be corrected 100%. With that being said we have seen some great results with a combo treatment of Profound and CO2. The profound will tighten the skin and the CO2 will provide a resurfacing. Make sure to consult with a local physician to make sure you are a candidate for these. Good luck!

Thank you for your question and pictures. Microneedling is a great treatment for acne scaring and multiple treatments are suggested. By looking at the pictures you provided, I would suggest researching the Sciton Profractional laser vs CO2 laser. Down time is needed after the procedures but, you will see a significant improvement with your acne scaring and over all texture of your skin,Best of luck,

Hi,
Thank you for reaching out. One of the best treatments for acne scarring is microneedling. Microneedling is a minimally invasive strategy for clearing up acne scars, lessening fine lines and wrinkles, and fading stretch marks. The treatment uses small needles to prick skin, prompting the creation of healing collagen.How can a little pen combat scars, wrinkles, and stretch marks? With a microneedling tool like the Rejuvapen, the clinician makes microscopic pricks on the skin. Those mini-needles the pen uses perforate the epidermis and the top layer of the dermis, holes so tiny that you can’t see them with the naked eye. Your skin realizes it must heal the injuries, so collagen and elastin flood the area, where they begin to regenerate and renew your skin.Following your treatment, your skin may feel warm and a little tight, and you may see redness or pinkness like a sunburn, but this usually recedes after about a day. Your clinician may recommend a balm or serum to lessen your discomfort after your treatment.

Thank you for your photos. You can treat acne scars by doing a series of treatments via LightPodNeo, Aerolase or PicoSure laser. The PicoSure laser is FDA-approved and is gentle on your skin, with minimal discomfort or downtime after treatments. PicoSure works by sending ultra-short pulses of laser energy into the outer and inner skin layers. The Aerolase laser aims laser technology into both the outer and inner layers of your skin. As it penetrates the deep layers of your dermis, it helps to combat bacteria and any other infections. It also will help reduce oil, swelling, and inflammation. I recommend getting a in person consultation with a board-certified dermatologist.

Surgical surgical surgical over laser. As above 3-4 sessions, then energy based micro needling RF, Pico will help with tiny pores but will do NOTHING for tethered scars. I like Picosure for end treatment after laser resurfacing if you are melanin rich- ie. Ethnic. Dr Rapaport is one of the more skilled dermatologist for this type of scarring. Manual over devices for the first few sessions will give you the best results. Lasers and energy devices help us, but skill sets for subcision using a NOKOR is my favourite tool for this job. I do respect other comments, as each Specialist has their own preferred method. I am just expressing mine.  For the best results, one should target the acne scar type with ideal treatments and not just one device. The web reference below will take you to a resource to help you understand acne scar revision at a specialist level. I embedded all the videos in one page to help.

For example deep ice pick scars, and narrow box car scars can be treated with TCA CROSS peels, mixed scars, rolling, and atrophic scars treated with fractional devices such as Fraxel, fractional lasers, PRP and INFINI radiofrequency. Atrophic scars (depressions) can be treated with either fat grafts, or with HA dermal fillers. Tethered and anchored scars are best treated with surgical techniques such as subcision. Other surgical techniques that we use include punch elevation, surgical elevation, punch excision and traditional excision of focal scars.

The majority of patients will have a collection of different scar types, and hence a tailored treatment METHOD will be best. Careful examination, especially under angled lighting with scar mapping will give you an understanding of what are the best options for your scars. In the majority of patients its finding the correct combination that give you best results, and everyone is unique! All the best,